scholarly journals The Transverse Process Trajectory Technique: An Alternative for Thoracic Pedicle Screw Implantation—Radiographic and Biomechanical Analysis

10.14444/8041 ◽  
2021 ◽  
pp. 8041
Author(s):  
Baron Lonner ◽  
Kushagra Verma ◽  
Chanland Roonprapunt ◽  
Yuan Ren ◽  
Casey A. Slattery ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Transverse Process ◽  
Biomechanical Analysis ◽  
Thoracic Pedicle Screw

scholarly journals Freehand thoracic pedicle screw technique using a uniform entry point and sagittal trajectory for all levels: preliminary clinical experience

2014 ◽  
Vol 21 (5) ◽  
pp. 778-784 ◽  
Author(s):  
Vernard S. Fennell ◽  
Sheri Palejwala ◽  
Jesse Skoch ◽  
David A. Stidd ◽  
Ali A. Baaj
Keyword(s):  
Pedicle Screw ◽  
Pedicle Screws ◽  
Transverse Process ◽  
Pedicle Screw Fixation ◽  
Entry Point ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Thoracic Pedicle Screw ◽  
Thoracic Pedicle Screws ◽  
Screw Diameter

Object Experience with freehand thoracic pedicle screw placement is well described in the literature. Published techniques rely on various starting points and trajectories for each level or segment of the thoracic spine. Furthermore, few studies provide specific guidance on sagittal and axial trajectories. The goal of this study was to propose a uniform entry point and sagittal trajectory for all thoracic levels during freehand pedicle screw placement and determine the accuracy of this technique. Methods The authors retrospectively reviewed postoperative CT scans of 33 consecutive patients who underwent open, freehand thoracic pedicle-screw fixation using a uniform entry point and sagittal trajectory for all levels. The same entry point for each level was defined as a point 3 mm caudal to the junction of the transverse process and the lateral margin of the superior articulating process, and the sagittal trajectory was always orthogonal to the dorsal curvature of the spine at that level. The medial angulation (axial trajectory) was approximately 30° at T-1 and T-2, and 20° from T-3 to T-12. Breach was defined as greater than 25% of the screw diameter residing outside of the pedicle or vertebral body. Results A total of 219 thoracic pedicle screws were placed with a 96% accuracy rate. There were no medial breaches and 9 minor lateral breaches (4.1%). None of the screws had to be repositioned postoperatively, and there were no neurovascular complications associated with the breaches. Conclusions It is feasible to place freehand thoracic pedicle screws using a uniform entry point and sagittal trajectory for all levels. The entry point does not have to be adjusted for each level as reported in existing studies, although this technique was not tested in severe scoliotic spines. While other techniques are effective and widely used, this particular method provides more specific parameters and may be easier to learn, teach, and adopt.

Straight-Forward Versus Anatomic Trajectory Technique of Thoracic Pedicle Screw Fixation: A Biomechanical Analysis

Spine ◽  
2003 ◽  
Vol 28 (18) ◽  
pp. 2058-2065 ◽  
Author(s):  
Ronald A. Lehman ◽  
David W. Polly ◽  
Timothy R. Kuklo ◽  
Bryan Cunningham ◽  
Kevin L. Kirk ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Biomechanical Analysis ◽  
Thoracic Pedicle Screw

Variability Analysis of Manual and Computer-Assisted Preoperative Thoracic Pedicle Screw Placement Planning

Spine ◽  
2018 ◽  
Vol 43 (21) ◽  
pp. 1487-1495 ◽  
Author(s):  
Dejan Knez ◽  
Janez Mohar ◽  
Robert J. Cirman ◽  
Boštjan Likar ◽  
Franjo Pernuš ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Placement ◽  
Computer Assisted ◽  
Pedicle Screw Placement ◽  
Variability Analysis ◽  
Thoracic Pedicle Screw

scholarly journals Learning Retention of Thoracic Pedicle Screw Placement Using a High-Resolution Augmented Reality Simulator With Haptic Feedback

2011 ◽  
Vol 69 (suppl_1) ◽  
pp. ons14-ons19 ◽  
Author(s):  
Cristian J Luciano ◽  
P Pat Banerjee ◽  
Brad Bellotte ◽  
G Michael Oh ◽  
Michael Lemole ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Pedicle Screw ◽  
Haptic Feedback ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Data Set ◽  
Learning Retention ◽  
Performance Accuracy ◽  
Thoracic Pedicle Screw ◽  
Thoracic Pedicle Screws

Abstract BACKGROUND: We evaluated the use of a part-task simulator with 3D and haptic feedback as a training tool for a common neurosurgical procedure - placement of thoracic pedicle screws. OBJECTIVE: To evaluate the learning retention of thoracic pedicle screw placement on a high-performance augmented reality and haptic technology workstation. METHODS: Fifty-one fellows and residents performed thoracic pedicle screw placement on the simulator. The virtual screws were drilled into a virtual patient's thoracic spine derived from a computed tomography data set of a real patient. RESULTS: With a 12.5% failure rate, a 2-proportion z test yielded P = .08. For performance accuracy, an aggregate Euclidean distance deviation from entry landmark on the pedicle and a similar deviation from the target landmark in the vertebral body yielded P = .04 from a 2-sample t test in which the rejected null hypothesis assumes no improvement in performance accuracy from the practice to the test sessions, and the alternative hypothesis assumes an improvement. CONCLUSION: The performance accuracy on the simulator was comparable to the accuracy reported in literature on recent retrospective evaluation of such placements. The failure rates indicated a minor drop from practice to test sessions, and also indicated a trend (P = .08) toward learning retention resulting in improvement from practice to test sessions. The performance accuracy showed a 15% mean score improvement and more than a 50% reduction in standard deviation from practice to test. It showed evidence (P = .04) of performance accuracy improvement from practice to test session.

Thoracic Pedicle Screw Insertion in Scoliosis Using Posteroanterior C-arm rotation Method

2005 ◽  
Vol 12 (2) ◽  
pp. 123
Author(s):  
Young Joon Ahn ◽  
Choon Sung Lee ◽  
Ji Hyo Kim ◽  
Kyeong Il Jeong ◽  
Yung Tae Kim
Keyword(s):  
Pedicle Screw ◽  
Screw Insertion ◽  
Pedicle Screw Insertion ◽  
Rotation Method ◽  
Thoracic Pedicle Screw
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